Manejo odontológico del paciente con frenillo lingual corto: a propósito de un caso / Dental management of the patient with short lingual frenulum: a case report

Introducción: El frenillo lingual corto puede provocar dificultades en la lactancia durante los primeros meses de vida en el neonato. A partir del desarrollo del lenguaje puede ser la causa de una fonética inadecuada. El tratamiento quirúrgico del frenillo debe ir acompañado por un adecuado tratamiento multidisciplinar para favorecer la corrección de las dificultades en la pronunciación. El objetivo del presente artículo es presentar un caso clínico representativo del diagnóstico, tratamiento quirúrgico y rehabilitación miofuncional del frenillo lingual corto, así como analizar la evidencia científica disponible. Caso clínico: Se presenta un paciente varón de 6 años diagnosticado de anquiloglosia severa que acude por dificultad en la pronunciación del fonema “RR”. Se realiza el tratamiento quirúrgico del frenillo mediante electrobisturí y su seguimiento por un logopeda. Conclusiones: El diagnóstico de la patología y la planificación quirúrgica y miofuncional deben tener en cuenta la clasificación del frenillo, la edad del paciente y la anatomía de la región. El tratamiento de la patología asociada al frenillo lingual corto requiere de un equipo multidisciplinar para evitar la recidiva. (AU)

Introduction: The short lingual frenulum can cause breastfeeding difficulties during the first months of life in the neonate. From language development they can be the cause of inadequate phonetics. Surgical treatment of the frenulum must be accompanied by adequate multidisciplinary treatment to improve the correction of pronunciation difficulties. The objective of this article is to present a representative clinical case of the diagnosis, surgical treatment and myofunctional rehabilitation of the short lingual frenulum, as well as to update the available scientific evidence. Case Report: A 6-year-old male patient is presented, diagnosed with severe ankyloglossia who came due to difficulty in pronouncing the phoneme “RR”. Surgical treatment of the frenulum was performed using electrocautery and its follow-up by a speech therapist. Conclusions: The diagnosis of the pathology and the surgical and myofunctional planning must take into account the classification of the frenulum, the age of the patient and the anatomy of the region. The treatment of the pathology associated with short lingual frenulum requires a multidisciplinary team to avoid recurrence. (AU)

Manejo odontológico del paciente con frenillo lingual corto: a propósito de un caso / Dental management of the patient with short lingual frenulum: a case report

Introducción: El frenillo lingual corto puede provocar dificultades en la lactancia durante los primeros meses de vida en el neonato. A partir del desarrollo del lenguaje puede ser la causa de una fonética inadecuada. El tratamiento quirúrgico del frenillo debe ir acompañado por un adecuado tratamiento multidisciplinar para favorecer la corrección de las dificultades en la pronunciación. El objetivo del presente artículo es presentar un caso clínico representativo del diagnóstico, tratamiento quirúrgico y rehabilitación miofuncional del frenillo lingual corto, así como analizar la evidencia científica disponible. Caso clínico: Se presenta un paciente varón de 6 años diagnosticado de anquiloglosia severa que acude por dificultad en la pronunciación del fonema “RR”. Se realiza el tratamiento quirúrgico del frenillo mediante electrobisturí y su seguimiento por un logopeda. Conclusiones: El diagnóstico de la patología y la planificación quirúrgica y miofuncional deben tener en cuenta la clasificación del frenillo, la edad del paciente y la anatomía de la región. El tratamiento de la patología asociada al frenillo lingual corto requiere de un equipo multidisciplinar para evitar la recidiva. (AU)

Introduction: The short lingual frenulum can cause breastfeeding difficulties during the first months of life in the neonate. From language development they can be the cause of inadequate phonetics. Surgical treatment of the frenulum must be accompanied by adequate multidisciplinary treatment to improve the correction of pronunciation difficulties. The objective of this article is to present a representative clinical case of the diagnosis, surgical treatment and myofunctional rehabilitation of the short lingual frenulum, as well as to update the available scientific evidence. Case Report: A 6-year-old male patient is presented, diagnosed with severe ankyloglossia who came due to difficulty in pronouncing the phoneme “RR”. Surgical treatment of the frenulum was performed using electrocautery and its follow-up by a speech therapist. Conclusions: The diagnosis of the pathology and the surgical and myofunctional planning must take into account the classification of the frenulum, the age of the patient and the anatomy of the region. The treatment of the pathology associated with short lingual frenulum requires a multidisciplinary team to avoid recurrence. (AU)

Functional Improvements of Speech, Feeding, and Sleep After Lingual Frenectomy Tongue-Tie Release: A Prospective Cohort Study.

Recent studies suggest that speech, solid feeding, and sleep difficulties may be linked to restricted tongue function. Children with tongue restrictions and speech, feeding, and sleep issues underwent lingual frenectomies with a CO2 laser, paired with myofunctional exercises. Questionnaires were completed before, 1 week after, and 1 month following treatment. Thirty-seven patients participated in the study (mean age 4.2 years [range 13 months to 12 years]). Overall, speech improved in 89%, solid feeding improved in 83%, and sleep improved in 83% of patients as reported by parents. Fifty percent (8/16) of speech-delayed children said new words after the procedure (P = .008), 76% (16/21) of slow eaters ate more rapidly (P < .001), and 72% (23/32) of restless sleepers slept less restlessly (P < .001). After tongue-tie releases paired with exercises, most children experience functional improvements in speech, feeding, and sleep. Providers should screen for oral restrictions in children and refer for treatment when functions are impaired.

Ankyloglossia: Surgical management and functional rehabilitation of tongue.

Ankyloglossia or "tongue-tie" is a rare congenital anomaly characterized by an abnormally short, thick, fibrosed lingual frenulum which may cause restriction in function of tongue including limitation in tongue movement. The lingual frenulum may be fibrous or muscular, and the tie may be complete or partial. Most often, ankyloglossia is seen as an isolated condition in an otherwise normal individual. This article reports the surgical management of a 20-year-old patient having ankyloglossia associated with restricted movement of tongue and difficulty in speech. The treatment involved is surgical removal of the lingual frenum followed by tongue training exercise and speech therapy to functionally rehabilitate the tongue. Six months postoperatively, the patient showed uneventful healing and was satisfied with the procedure.

The prevalence of ankyloglossia in 302 newborns with breastfeeding problems and sucking difficulties in Barcelona: a descriptive study.

AIM: Oral and maxillofacial development is influenced by the lingual frenulum and also affects breathing, occlusion, sucking, swallowing, speech, among others. Ankyloglossia in the newborn may result in breastfeeding difficulties: maternal nipple pain and/or erosion or mastitis, poor weight gain and excessively long breastfeeds. The main objective of this work is to study the prevalence of ankyloglossia in newborns with breastfeeding difficulties. MATERIALS AND METHODS: This is a transversal descriptive study of 302 patients, between 0 and 6 months, who attended the hospital as a result of breastfeeding difficulties. All patients with sucking problems and ankyloglossia were included in this study and followed the multidisciplinary treatment protocol made up of the services of Breastfeeding, Speech Therapy and Orofacial Rehabilitation and Oral and Maxillofacial Surgery. RESULTS: 1,102 newborns were seen at the paediatric service of Hospital de Nens, Barcelona (Spain) during 2 years; 302 had breastfeeding difficulties and of these, 171 were diagnosed with ankyloglossia (60 girls and 111 boys). Coryllos Grade 3 ankyloglossia was the most prevalent (59.6%) type; 85 infants (49.7%) were exclusively breastfed and 26 (50.35%) were mixed fed (formula and breastfeeding). Only 43 patients had a family history of tongue-tie (25.1%). CONCLUSION: Ankyloglossia linked to breastfeeding difficulties must be treated by a multidisciplinary team. We have found a high prevalence of the condition since the population studied are newborns with sucking problems. If a frenotomy is necessary, we recommend stimulating suction with myofunctional therapy before and after surgery to avoid scar retraction.